The purpose of this project is to develop a measure of biologically based clinical judgment that will reflect the frequency of occurrence of the judgmental process used in dental practice. The quantification is based on the frequency of categories reported by defined groups of health professionals using a modified critical incident technique (FJKT - Functional Job Knowledge Test). Since the probability of recall of a category in responding to the FJKT depends on frequency of usage, the reported data are assumed to describe actual activity in dental practice. Since clinical judgments are crucial to quality health care delivery, it is important to measure their use, so they can be monitored after being influenced by interventions (e.g., continuing education with computer simulations). Fourteen thousand incidents occurring in clinical situations have been collected from 4,000 providers of dental care over a 20 year period. These data will be used to develop a reliable, valid category system for biologically based judgmental processes used in clinical dentistry. Initially the categories will be deduced from literature review. Later, categories will be modified from induction during data analysis. Rules for categorizing will be defined and modified until the rules can be used reliably by different judges. Both category development and realiable use will require numerous iterations using randomly drawn samples of incidents. The realiability of categorization will be determined by replication of paired judges on two sets of 100 randomly drawn incidents. Using the same rules, two pairs of judges will categorize incidents. The percentage agreement corrected for chance will be determined within and between judges in each pair. The validity will be further checked by measuring groups receiving differential judgment training. Groups trained in the past few years in a dental college which emphasizes clinical judgment will be compared against groups trained 20 years ago in which less emphasis was placed on the use of biological information in clinical decisions. The instrument should differentiate between the two groups showing a broader range of category usage in the more recent groups. The reports of groups used for this validity comparison will be drawn from the existing data bank.